Jump to content
×
Are you looking for the BariatricPal Store? Go now!

How much did you pay out of pocket?



Recommended Posts

I have Anthem Blue cross insurance. They cover 80% of the costs, and I have a consult with a preferred provider. How much would you expect my costs to be? Is there in house financing for this?

Thank you!

Share this post


Link to post
Share on other sites

I have TRS Active Care with Aetna. They require a 5K co-pay, 20% of the surgery, the 'usual' doctor visits are paid at the regular rate (I think $50 a visit) AFTER the $2,500 deductible is paid and require a 3 month diet plan. That means about $10K out of pocket (mainly because my insurance re-sets on Sept 1st and it is not enough time for the 3 month diet and I have to meet my insurance deductible again).

To self pay with Southwest Baratrics is...about 10K... To go with Dr. Ganta (whom I really like) is about 13K..

Sigh.

Share this post


Link to post
Share on other sites

It really depends on how much the hospital/surgeon you are going to charges. I have seen a huge variance of how much places charge. Everything from 5k (Mexico) all the way up to 50k+. At 80% coverage, if your surgery is 10k, your share would be 2k, but if they charge 50k, your share would be 10k.

My hospital charged my insurance $45,000 for my surgery (with an additional $2,300 for the anesthesiologist who billed separately). Thankfully my insurance paid for it and I didn't have to pay anything out of pocket.

Share this post


Link to post
Share on other sites

Wow, yeah... this is going to be a challenge! Hopefully I will get more answers on the 1st. I have so many questions!

Share this post


Link to post
Share on other sites

A good rule of thumb is look at your oop, that's normally the max you would pay. Unless the facility bills something that's "not covered".

Share this post


Link to post
Share on other sites

@@PixelToph @@Tina4heath4ever

Usually the 80% is the allowed amount by the insurance and it is irrelevant how much the hospital/surgeon charges. You can ask your BCBS plan what the allowed amount is for that procedure - but be aware that there will be additional charges on top of just the surgery (anesthesia, hospital days, medications, iv's, supplies, etc.) that you may have to pay a portion of as well. Your surgeon and hospital will go over all of this with you prior to surgery (no doubt) - and many will require payment upfront for a elective surgery. If you have a max out of pocket expense - look into that as well (it may cut down the amount you'd have to pay out of pocket).

Share this post


Link to post
Share on other sites

According to my doctor, the procedure costs $17,500 (including inpatient stay, etc). My insurance covers my procedure (vsg) at 100%, no copay, no coinsurance and no deductible/out of pocket applies. All I have to pay is the $40 specialist office visit copay and a $300 program fee for 10 visits with cardiac rehab (exercise visits) and 3 visits with a nutritionist. All in all, I will be paying $540 out of pocket. I was lucky in this respect since I happen to work at the hospital where I will eventually (fingers crossed) get the surgery

Share this post


Link to post
Share on other sites

I have Anthem Blue cross insurance. They cover 80% of the costs, and I have a consult with a preferred provider. How much would you expect my costs to be? Is there in house financing for this?

Thank you!

My anthem covers 90%

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

There are many out of pocket costs pre surgery consults with potentially many doctors to get cleared for surgery. Between the requirements to send in to BCBS and my surgeon wanting me to get cleared I ended up having to see so many specialists. One would clear but then what a different specialist to clear me also, this went on and on with invasive testing with all results coming back just fine. This added up to over $650 out of pocket so far. I am approved for surgery by BCBS. But I had no idea I'd have these out of pocket costs before even going in under the knife. I would imagine this would be difficult for some.

Share this post


Link to post
Share on other sites

Do you have to pay your deductible before you can have the surgery?

Share this post


Link to post
Share on other sites

You generally get billed after the surgery for whatever the cost are, at least that's been my experience.

"We can't solve problems by using the same kind of thinking we used when we created them"

Einstein

Share this post


Link to post
Share on other sites

I paid 15k out of pocket. If I could do it all over again, I'd have run off to Mexico and saved a bundle! :)

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
    • RacMag  »  bhogue925

      Hi, I’m new here. I’m currently on the liver shrinking diet. So far so good, but I have to say I haven’t found a protein shake I like. Anyone have any suggestions please? My surgery date is September 17th. 
      · 2 replies
      1. BlondePatriotInCDA

        Fairlife Core are by far the best. They taste just as they are - chocolate milk. You can either get the 26 grams or the 42 grams (harder to find and more expensive). For straight protein look at Bulksuppliments.com ..they have really good whey proteins and offer auto ship plus they test for purity. No taste or smell...

      2. BlondePatriotInCDA

        Fairlife has strawberry, vanilla and of course chocolate. No more calories than other protein drinks. Stay away from Premiere, they're dealing with lawsuits due to not being honest about protein content.

    • Doctor-Links

      HGH For Sale
      hgh for sale at our online pharmacy
       
      Human growth hormone (HGH) is a small protein which is made in part of the brain called the pituitary gland. It travels in your bloodstream all over your body to make your body grow.
      HGH is very important in the body. It is needed for children to grow normally. It helps make sure there is enough muscle and fat in the body. It keeps our bones healthy.
      Buy Rybelsus online, Rybelsus tablets
      You can order for wegovy at our online pharmacy
      Check for the prices of 0.25mg, 0.5mg and 1mg at our online pharmacy and buy ozempic.
      · 0 replies
      1. This update has no replies.
    • Doctor-Links

      hgh kaufen  in unserer Online-Apotheke  
      Menschliches Wachstumshormon (HGH) ist ein kleines Protein, das in einem Teil des Gehirns, der Hypophyse, produziert wird. Es wandert in Ihrem Blutkreislauf durch Ihren ganzen Körper, um Ihren Körper wachsen zu lassen.
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×